Extracorporeal Cardiopulmonary Resuscitation, Out of Hospital Cardiac Arrest
Conditions
Keywords
ECMO, ECPR, Extracorporeal membrane oxygenation, ECMO CPR, at the scene, scene based, OHCA
Brief summary
CHEER4TTE is a target trial emulation, designed to simulate a randomised controlled trial by utilising data from pre-existing data sources. The aim is to determine whether prehospital ECPR for refractory out-of-hospital cardiac arrest improves the rate of survival to hospital discharge when compared to conventional cardiac arrest care.
Interventions
The Intervention being evaluated is the initiation of extracorporeal cardiopulmonary resuscitation (ECPR) at the scene, in addition to conventional cardiac arrest care.
Sponsors
Australian and New Zealand Intensive Care Research Centre
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Witnessed cardiac arrest * Bystander CPR * Refractory cardiac arrest (failure to achieve sustained ROSC \>20 minutes) * Initial cardiac rhythm VF, VT or PEA * Within the hours of prehospital ECPR service operation
Exclusion criteria
* Initial cardiac rhythm asystole * ROSC with sustained recovery * Unable to reach the patient and commence cannulation within 45 minutes of onset of arrest * Evidence of/suspected end-stage disease: * severe disability impairing activities of daily living * end-stage organ disease - cardiac, liver, lung, renal * other life-limiting diseases, e.g. malignancy, terminal illness * advance health care directive * Time periods of advanced public health restrictions in Victoria and NSW due to COVID-19
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Survival to hospital discharge | From meeting full eligibility criteria until the date/time of death or hospital discharge, assessed up to 180 days |
Secondary
| Measure | Time frame |
|---|---|
| Low flow time | time from onset of arrest to time of ECPR flow, or time of death |
| ICU length of stay | From the date/time of ICU admission until the date/time of ICU discharge/death, assessed up to 180 days |
| Mechanical ventilation days | From date/time of mechanical ventilation commencement until date/time of liberation from mechanical ventilation assessed up to 180 days |
| ECMO complications | From the date/time of commencement of ECMO support until 1 week following the date/time of cessation of ECMO support |
| Rates of organ and tissue donation in non-survivors | In the 48hours following date/time of death |
Countries
Australia
Outcome results
None listed